by Stephen Wade
This was not, in any way possible, a good sign. But Dr Lewis saw Sarah and he reported:
On Wednesday, December 15th – the sixth day of the watching – I found her at 3 p.m. much the same in appearance; the voice a little more feeble; pulse 120, variable, sometimes more frequent. The right hand at first felt cold, but after being covered by a shawl, it became quite warm. The face was not so flushed as on the 9th instant; still there was a dusky redness of the cheeks and nose. She stated that she felt pretty well; she had no pain. She had never asked for any description of food or drink…. With the exception of the quick pulse, there was no alarming symptom about the girl…
This report would have increasingly perplexed anyone studying the case. Starvation means emaciation, visible ribs, hollow faces with the cheek-bones prominent, and so on. Here was Sarah, still with a dusky redness. Yet the ketosis shows that depleted stores of all sources of fat was surely a cause for concern. But Dr Lewis added that he did not anticipate ‘immediate danger of life’.
Ketosis is not by any means ‘the smell of death’ and in more recent times, aiming at ketosis has been one of the primary aims of certain low carb diets. Yet as we shall discuss later, Sarah’s decline not long after the nurses came is almost certainly related to other causes; the ketosis was simply a sign of the fat-breaking process, when ketones are produced in greater number and more quickly, as a low carb diet makes fatty tissue become depleted, and the liver takes on the uses of the stored fat.
Then on the 16th there was a notable change. Sarah became restless and distraught. She did not read, as usual. Her parents were always there, helping to make her comfortable, but at that time, there had been no urine for a day, and that, combined with the ketosis, was indicative of a rapid decline towards death. The vicar was very worried and he suspected that, whatever the source of her strength was before the nurses came, she should be left alone for that to happen again. Her parents would not agree to that at all.
The next day, her uncle, John Daniel, came to see her and begged Evan to act, but he would not. When Daniel offered Sarah a little water, there was the fit again – simulated, in accord with previous behaviour, maybe even done with an awareness that her father was present, vigilant as always.
Dr Lewis also asked Evan to agree to the cancellation of the nurses’ watch. The father could not agree – he saw Sarah’s condition as something familiar, nothing to worry about. Once again, he refused to listen to medical advice. The doctors were beginning to see the deepening problem: it was going to be difficult to explain the dominance of the family over the professionals. Mr Rowlands had left the group earlier, and on the 16th Dr Hughes of Carmarthen resigned. This was as, in the words of Dr Lewis, Sarah was ‘threatening to sink’. Hughes wrote that he was resigning because he had not been allowed to make a proper examination of the girl. He said, ‘I am not allowed to see her tongue, or touch her face, nor to examine her person, except that once I was allowed to feel her arm through her dress.’ The fact was that Evan was ‘keeping a vow’ he had made two years before to Sarah, that he would not give her food.
Dr Lewis continued to report to the British Medical Journal, and his findings are the most detailed after the long assessment earlier by Dr Fowler. His was the last full examination (as much as was allowed) and was made on the 16th, and shows that the doctors were not enjoying entirely amicable relations. Lewis notes that ‘Her face looked more natural than on the previous day; the livid redness of her nose and the excessive flush of her cheeks had disappeared. The general colour of her face was clear and natural.’ Yet, Hughes was not in agreement. The doctors prevaricated and debated, but by the evening no-one appeared to think that Sarah’s life was in danger.
There is no doubt that, looking carefully at Evan Jacob’s behaviour and attitudes during and shortly before the second watching, there was the possibility of collusion, in the psychological sense, going on. I will return to this later when the medical theories are recounted, but for now, enough to say that Evan’s anger at Daniel’s suggestions tells us a lot. Evan’s anger was extreme when Daniel suggested food should be given. It was related that the father lost his temper, and was evidently so set on keeping that ‘vow’ that he would not relent one jot, regardless of the medical reports. He appears unwilling to see the deterioration which was taking place before his eyes.
Late on the evening of the 16th the slide down from signs of normal healthiness was notable; the Sister Clinch saw that her charge was sinking. The girl called for her parents, but Evan could only attend to the obvious, keeping her warm by putting her little sister into bed with her. Although Sarah had muttered something in Welsh, Nurse Jones could not interpret, so delirious and restless was the patient. Still all food and drink was refused by Evan and Hannah – even a little brandy. In the early hours of the next morning, Sister saw that something drastic had to be done as the girl’s life was under threat.
Mr Davies came from Llandysul and asked if she could be given brandy, but still there was no change in attitude from Evan; he kept quiet until, perhaps at last feeling some real fear, he agreed. But then the doctor refused, as he was aware that any action taken if death resulted might rebound on him later. Then Davies suggested that the nurses leave, implying that the girl had somehow lived while solely in the care of her parents, and of course, that was taken as an insult by the professionals.
The adults were dithering and playing gambits in a context of fear for reputation and doing the right thing. All the while, Sarah was near to death, and as the family and the nurses sat with the sleeping girl, the vigil ended as Sarah’s life ebbed away. She died at mid-afternoon just before Christmas – 17th December, 1869.
The Western Mail had no doubt that something horrendously criminal had taken place. It reported on Christmas Day that ‘The girl was undoubtedly starved to death, and the question is who was responsible for her starvation?’ The leader also expressed, simply but powerfully, what most were thinking: ‘The medical evidence appears to have shown, in the first place, that the general condition of the girl was healthy. She must have been fairly well nourished up to the time the watching began.’
The sad news spread rapidly across the country to all main regional presses, and there is no doubt that journalists wanted to squeeze out every scrap of sensation. Readers had followed the bulletins from the nurses, and their monitoring had also been posted in the British Medical Journal, so the whole business had the feel of something between a piece of reportage from the front line of Science v Superstition and a laboratory experiment. A report in the Dundee Courier was aggressively forthright in its condemnation: ‘For six or eight months this girl, and those responsible for her, had been imposing upon the public by pretending that she lived without nourishment. Many persons, including, if we remember rightly, one or more men of the medical profession, had brought themselves to believe that the girl really subsisted without food.’
Inevitably, ‘the end of an imposture’ was a common headline and that feeling was followed by calls for acknowledgement of some criminal action and responsibility. The Western Mail at first merely expressed astonishment: ‘The question is now seriously asked, how is it that the doctors and nurses, who knew that the girl was weak and ill, did not take her to some nourishment. That they did not do so, is, to say the least of it, strange.’ Then the paper sent a special correspondent to the inquest, with the beginnings of talk about responsibility, and he wrote: ‘It is stated though Mr Jacob declined to have legal advice, that his relatives thought it to be advisable, and have prevailed upon him to employ a solicitor to watch the case tomorrow on his behalf…’
Sarah’s death was to be the beginning of a criminal prosecution which, as some commentators have noted, should have become a leading case rather than a curiosity. But for the time being, there was an inquest to deal with, and lots of talk about death and dying, something the Victorians did thoroughly and with style. Generally, as inquests were held in pubs and inns, the locals would have been expecting a
ll to be revealed in the proceedings. That is, normally the body was placed on a trestle or table for all to see, so that identification could be made and verified by second testimony. Also, wounds referred to in the discussion could be pointed out. They were not occasions for the squeamish. In most places at the time, an inquest was rather sensational, something of a spectacle in fact, yet we have no record of Sarah’s body being there. This one of the lacunae in the sources: was her body there? It appears that the autopsy was being done, and the authorities saw no reason for identification. It was not a sudden and mysterious death, so it would have been bad form and unnecessary to have her body there. But still, the public must have wanted to know what she was like after dying through starvation.
5
A ‘Good’ Celebrity Death
One more unfortunate
Weary of breath
Rashly importunate
Gone to her death
Thomas Hood: The Bridge of Sighs
Sarah Jacob died in the bed in which she had spent two years in the desolate long house, for much of that time merely the subject of chatter amongst the neighbours. Even before she was famous, the dwelling in the sick bed had attained the nature of massive spiritual significance. The reason for this is to be found in the way that young Victorians were expected to die.
The nineteenth century, particularly with the expansion of nonconformist and evangelist worship and propaganda from the last years of the Regency to the ‘High Victorian’ years, handled death with profound interest and great expertise. There was a solidly established set of texts and discourse on death, especially of infant and adolescent death. The literature dealing with this was massive and influential. A classic template for the reporting of a ‘Good’ death is found, for instance, in The Youth’s Instructer [sic] and Guardian for 1834. One of their key texts was ‘When the bridegroom shall be taken away, then shall they fast in those days’ – linked to disquisitions on ‘The Primitive Christians’. Time and time again, the periodical preached a doctrine perhaps best summed up in the words ‘They valued only inward greatness’. It is not difficult to imagine Sarah reading and taking in such ideologies.
Then we have the cult of good dying that the periodical inculcated. Every issue carried a feature called ‘Juvenile Obituary’ which presented a meticulous account of a doomed child in her bed, destined to ‘step to Heaven with her Lord’. For instance, when Sarah Middleton died at Scarborough, the obituary described the course of her dying, focusing on the nobility of her suffering: ‘The delicate state of her health for the last few years, and the frequent attacks of illness she experienced, were made special blessings to her. She invariably came out of the furnace more alive to God, more humble, more spiritual and heavenly-minded. It was evident that she had been, in a more than ordinary degree, with Jesus.’
The obituaries in the Instructer and Guardian, as with the visiting of Sarah, made the dying chamber and bed a place of special visitation and reverence:
Her Class-Leader [Sunday School] was often blessed in his visits to her sick chamber, and had the happiness to find that she was generally favoured with the abiding presence of the Lord; that Death had lost his sting; and that she could read her title clear to the mansion in the skies.
Her death was an occasion for a dialogue with her sister, and the final words were grand and composed: ‘… she appeared more composed, asked for a little orange and water, and seemed to fall into a comfortable sleep; but soon awakening, she looked around on the persons present, and with an aspect never to be forgotten, exclaimed, I am going to Jesus.’
The journal presents many of these obituaries, each with a lyrical, triumphant statement of the death:
…her happy spirit was admitted into that world where the weary are forever at rest. Thus died, aged sixteen, Mary Ann Mitchell, deeply lamented…
During the last night of her life she broke out in praise of God, singing many of her favourite hymns… Thus she continued to sing and give thanks, till Sunday morning when her happy spirit was released. (Sarah Ann Walker, 14)
She manifested her concern for the spiritual welfare of others, by the warnings and advice she gave them; and when aware that the time of her departure was at hand, in answer to the enquiries of her Christian friends, she said “I am happy. I am not afraid to die.” (Hannah Adkinson, 16)
Her aged father came to see her: and for his salvation she was much concerned. She entreated him, with tears trickling down her face, to give his heart to God; and when he was about to leave her, she threw her arms around his neck and said, “Father, will you give your heart to God? I shall perhaps see you no more in this world and I should like to meet you in Heaven.” Whenever she had an opportunity of speaking to her Lord, she did not let it pass unimproved. She had much of divine love, and her heart often overflowed with peace and joy.
What strikes us here is that, for the thinking behind these ‘Good Deaths’ one of the purposes of the death bed sacredness and display, was that it was an occasion for salvation. The sufferer was a focus for the repentance of sinners, because he or she was ‘one step from Heaven’. Is there something of this in Sarah’s fasting? It appears highly likely that the sustained period in the bedroom, with the trappings and flowers, books and poems, was that she was seen by visitors as a source of religious and spiritual sustenance. You visited the dying young person to absorb some of their holiness as they waited for the end. That maybe puts it a little too strongly, but for a world in which death was just beyond a thin veil, always waiting in the wings, a young person was of special significance, with the roots of the meanings of course, in ‘suffer the little children’ – the child was closer to Jesus and at the point of death, their words should be heeded.
In the mid-Victorian years the conventional ‘Good Death’ of young girls related to an idealisation, based mainly on the universality of tuberculosis. In 1858, Henry Peach Robinson produced a death bed scene made from five negatives he called ‘Fading Away’ which shows a young girl dressed in white, lying in bed and dying of tuberculosis; a woman stands behind her head and another woman sits, with a book, by the bed-end. A male figure stares out of the window and we only see his dark outline. This photograph was very popular, and the image is idealised romanticism.
The picture illustrated the thinking behind the ‘Good Death’ – that it was a depiction of death as a composed time, one in which clear thinking and a focus on the next world were possible, rather than in the harsh reality in which there would have been nothing whatsoever romantic in a death from that horrendous disease.
The point is in the contrast. A typical Victorian death at the time would have been a matter for regular, familiar actions and the accepted ritual. Of course the suffering was there, and the anguish of all concerned, but in Sarah’s case, although professionals stood present and she died at home in her bed, her end was anything but regular and understood. She died in an atmosphere of chaos, confusion and strange, twisted thinking which imposed on the situation nothing short of a dark, surreal farewell to the world, quite the opposite of the deaths recounted in the Instructer and Guardian.
In this climate of the iconography and grand narrative of the ‘Good Death’, the process of law had to begin. The first step was the inquest. What had been in most minds an improbable and mystical local phenomenon had become a hard and shocking fact: a little girl had died, and she had died while in the care of nurses from London and of several local medical men.
Many inquests were held in pubs and other places with no official status, and Sarah’s was held at New Inn, in the home of Ann Charles. The correspondent for the Western Mail wrote that Charles’ place ‘happens to be the very oldest house in a block of whitewashed, brown-thatched, teacaddy-looking barns…’. The same writer left a vivid account of the inquest as an attraction to travellers and the curious rabble who wanted to be there, to taste of the scandal: ‘The subject has been in everyone’s mouth all day today; and as each train on the Carmarthen and Cardigan Railway made
its usual halt at Pencader, the shivering passengers availed themselves of the hospitable refreshments, where warmth and comfort and “a nip of the creatur” awaited them in this wilderness of cold and isolation.’
The coroner George Thomas began proceedings on 21 December. An inquest explores the circumstances surrounding a death, to decide whether there is anything suspicious, such as the possibility of suicide, murder or manslaughter. If a criminal action is suspected, then the person in view will be committed for trial at a court of criminal law. Since 1836 legislation had been passed to give coroners the power to insist on the submission of medical evidence, including post mortems. The coroner’s court was viewed as rather more influential after that, doing much more than having the body open to general inspection and questions put to witnesses. One commentator wrote that by the 1840s such a court was seen as ‘a medico-legal investigation’. The community around New Inn and Pencader at the time, along with the wider world from Carmarthen to London, would have expected the Jacobs to be charged.
Everything depended on the outcome of the autopsy, as it still does, and three doctors had undertaken the task – James Thomas, Phillips and Lewis. The latter was to publish a detailed account of the autopsy in the British Medical Journal on January 8 following, but at the inquest, Thomas was sworn in and then Phillips, both making it clear that there were certain matters which would open up some important thinking. Thomas pointed out that ‘The small intestines were empty, but the colon and rectum contained about half a pound of excrement, in a hard state.’ Otherwise, her organs were healthy, and the brain was ‘perfectly healthy and of proper consistence’. The excrement, he said, had been there for two weeks. Having to give the cause of death, he moved on from the physiological and said that Sarah had died through lack of food, but that hysteria was her primary condition, adding that this had been ‘frequently showing itself in most extraordinary freaks, and in her case by refusing to take food in public.’